Re-entry, Homelessness, and Children Healthcare Tops HHSA Committee’s Agenda

The 2017-2018 Health and Human Services and Aging Committee convened their first meeting on Wednesday, January 18, 2017. The committee is now chaired by District 7 County Councilwoman Yvonne Conwell. Vice Chair of the committee is newly elected County Councilman Scott Tuma.  Councilwoman Shontel Brown and Councilman Dale Miller remain on the committee, where they are joined by newly appointed Councilwoman Nan Baker. Former Chairman of HHSA Pernel Jones, though not part of the committee, attended this first meeting as an interested Council member.

Mary Kelly, from Cuyahoga County Health and Human Services (HHS) Office of Reentry, testified before the committee for a contract renewal for Oriana House, which operates a facility known as Northstar, located at 1834 East 55th Street. Oriana was the only organization to respond to a Request For Proposal for services to serve the reentry population, which allocates $600,000 per year for three years, including operating costs and personnel. Northstar is open 60 hours a week, with free parking, and prepares citizens returning from prison as they transition back to civilian life. At Northstar, participants learn valuable life skills in interpersonal communication, can take classes that lead to a GED, as well as meet with staff for student aid or job preparation. The facility also serves as a base for other groups such as Alcoholics Anonymous. This is the third three-year contract that Orianna House has signed with the County to support Northstar.  The latest contract will run from January 1, 2017, to December 31, 2019.

Council members had a number of questions about the contract. Councilwoman Brown asked how the contract was advertised. Ms. Kelly responded that the RFP was posted in both traditional and social media, and was open for approximately three weeks. Councilwoman Brown suggested that for such a large contract, three weeks is far too short for competing proposals to be created and submitted to the County.

Along those same lines, HHSA Committee Chair Yvonne Conwell asked why the contract was coming before the committee, after the contract has already begun. Chairwoman Conwell shared that she has seen this quick turnaround required repeatedly during her tenure on the HHSA Committee and encouraged the Reentry Department and others to put their contracts out to bid earlier, so that the contracts received can go through the process and get approved prior to execution.

Councilwoman Nan Baker had questions about the measurements, such as if the number of clients served included individuals who returned to the facility several times for services (known as “duplicated” clients), or if the number was the number of “unique” visitors over the course of the year. According to the data provided to Council, the facility served over 27,000 client visits per year.  It is not clear if these are duplicated clients or unique clients. Additionally, there were some unanswered questions from the reporting numbers, such as why the library usage was reported as zero, even though that was  not the case, based on the testimony provided by the Office of Reentry that the library is frequently used by visitors.

The committee passed the RFP request out of committee under second reading suspension, which means that there does not need to be three readings and the resolution is immediately forwarded to the full Council.

February 1, 2017

The second meeting of the year for the Cuyahoga County Council Health, Human Services and Aging Committee featured testimony for two contracts.

The first presentation was from Karen Stormann, program administrator for Cuyahoga County Children and Family Services (CFS), to renew a $1.8 million contract with MetroHealth that provides critical services to families who enter the Child and Family Services system: psychiatric medication consultation for children in foster care, a medical home for children in foster care, which streamlines triage and post-placement for families, and toxicology to the agency for substance abuse testing for the families that come in and work with CFS.

MetroHealth connects children who are in need of social services to CFS social workers 24/7 to ensure that they get the support that they need and get placed quickly.

Approximately 35 percent of children who enter foster care are on some type of psychotropic medication, so CFS relies on the expertise of MetroHealth to verify that the children get exactly what they need and the appropriate dosage.

Chairwoman Conwell asked how the contract funding is broken down between the County and the State. Approximately 30 percent of funding for this contract comes from Medicaid funding, and the remaining 70 percent of funding comes from county Health and Human Services Levy dollars. Chairwoman Conwell also asked about the tracking of the children once they are admitted into County custody. Ms. Stormann testified that children are tracked in a database at MetroHealth, as well as a database with the County. In 2016, MetroHealth had 34,000 encounters with the public, of those encounters, 1,800 were children who were admitted through the triage program. On any given day, CFS has approximately 1,800 children in custody.

Once screened by MetroHealth, upon entry into the County system, families may continue to use MetroHealth as their health care provider, or they may go see other doctors. Both the children and the parents receive a Medicaid card to ensure that they are covered.

Echoing comments in other meetings, Chairwoman Conwell noted how many of the Health and Human Service contracts are coming before the committee after the contract has already started. Because of this, many contracts must be passed out of committee under “second reading suspension.” Chairwoman Conwell said that she is a “stickler for three readings.” She ended her comments by saying “we can do better.”

The second contract that came before the County was an amendment to extend the existing contracts for 2100 Lakeside, which is a men’s homeless shelter, and Norma Herr, which is a women’s homeless Shelter, to April 30, 2017. The extensions would be for approximately $482,000 for the Norma Herr women’s shelter, located at 2227 Payne Avenue and operated by FrontLine services, and $567,000 for the men’s shelter operated by Lutheran Metropolitan Ministry. The total cost of the contract extensions is approximately $1.04 million. The annual total budget for the men’s shelter is $1.7M and for the women’s shelter is $1.48M.

Ruth Gillett, administrator for the Office of Homeless Services (OHS), appeared before the committee and explained that the original contracts were to end on December 31, 2016. The County did an RFP process last year, but there was only one provider (FrontLine) that responded. There was considerable pushback from the community last year, as many citizens argued there was not enough time for other providers to respond to the RFP. The County then decided to extend the contracts until April 30, 2017, and issue another Request for Proposal, this time with a slightly longer response period. In the meantime, the County must extend the existing contracts to continue making payments, while the responses to the RFP are evaluated.

The deadline for the RFP was January 31, 2017, and three providers had responded. A committee of several community representatives will be responsible for reviewing the proposals, including representatives from United Way, the City of Cleveland, the ADAMHS (Alcohol, Drug Addiction, and Mental Health Services) Board of Cuyahoga County, and others.

Newly appointed County Councilwoman Nan Baker asked if homeless shelters focus on skill development. Administrator Gillette explained that there used to be a push at the federal level to get homeless individuals to pursue things like GED, and mental health and other case management services.  However, 15 years ago, there was a shift at the federal level to focus more on transitioning individuals to housing, as many of them already had relationships with other educational and social services that could meet their skill development needs. Now the County focuses on housing, while connecting them with other county agencies such as Job and Family Services and the ADAMHS Board.

Councilman Miller sought clarity on the three providers that had responded to the new RFP. Administrator Gillette replied that she has not had a chance to pick up the responses yet to see who they are. The new contract would begin in May, 2017, and end at the end of 2017, with optional extensions for 2018 and 2019. Councilman Miller requested the committee be informed of who the respondents were when OHS comes back before the committee.

The contract extensions were passed out of the committee by second reading suspension for approval to the full Council.